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Cognitive behaviour therapy meets psychopharmacotherapy

Published online by Cambridge University Press:  03 November 2010

David Veale  and
Anna Stout
David Veale*
Affiliation:
NIHR Biomedical Research Centre for Mental Health, The South London and Maudsley NHS Foumdation Trust & The Institute of Psychiatry, King's College London, UK
Anna Stout
Affiliation:
NIHR Biomedical Research Centre for Mental Health, The South London and Maudsley NHS Foumdation Trust & The Institute of Psychiatry, King's College London, UK
*
*Author for correspondence: Dr D. Veale, Centre for Anxiety Disorders and Trauma, The Maudsley Hospital, 99 Denmark Hill, London SE5 8AZ, UK. (email: [email protected])
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Abstract

This article provides an overview of the role of psychopharmacotherapy in common emotional disorders for cognitive behaviour therapists. We consider some of the philosophical difference between CBT and medication, when medication might interfere with CBT, when it may enhance outcome and when it might be safely discontinued. We highlight how to differentiate side-effects and symptoms of discontinuation of antidepressants from that of the underlying disorder. The scope of this article is confined to common emotional disorders and does not discuss the interaction of CBT with medication in, e.g. schizophrenia, bipolar disorder or dementia.

Keywords

Cognitive behaviour therapypharmacotherapy
Type
Practice article
Information
the Cognitive Behaviour Therapist , Volume 3 , Issue 4 , December 2010 , pp. 117 - 131
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2010

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References

APA, (2010). Practice guidelines (www.psychiatryonline.com/pracGuide/pracGuidehome.aspx). American Psychiatric Association. Accessed 27 September 2007.Google Scholar
Baldwin, DS, Anderson, IM, Nutt, DJ, Bandelow, B, Bond, A, Davidson, JRT, Den Boer, JA, Fineberg, NA, Knapp, M, Scott, J, Wittchen, H-U (2005). Evidence-based guidelines for the pharmacological treatment of anxiety disorders: recommendations from the British Association for Psychopharmacology. Journal of Psychopharmacology 19, 567–596.CrossRefGoogle ScholarPubMed
Bandelow, B, Seidler-Brandler, U, Becker, A, Wedekind, D, Rüther, E (2007). Meta-analysis of randomized controlled comparisons of psychopharmacological and psychological treatments for anxiety disorders. World Journal of Biological Psychiatry 8, 175–187.CrossRefGoogle ScholarPubMed
Barlow, DH, Gorman, JM, Shear, MK, Woods, SW (2000). Cognitive-behavioral therapy, imipramine, or their combination for panic disorder: a randomized controlled trial. Journal of the American Medical Association 283, 2529–2536.CrossRefGoogle ScholarPubMed
Bissada, H, Tasca, GA, Barber, AM, Bradwejn, J (2008). Olanzapine in the treatment of low body weight and obsessive thinking in women with anorexia nervosa: a randomized, double-blind, placebo-controlled trial. American Journal of Psychiatry 165, 1281–1288.CrossRefGoogle ScholarPubMed
Bisson, JI (2007). Pharmacological treatment of post-traumatic stress disorder. Advances in Psychiatric Treatment 13, 119–126.CrossRefGoogle Scholar
Blomhoff, S, Tangen Haug, T, Hellstrom, K, Holme, I, Humble, M, Madsbu, HP, Wold, JE (2001). Randomised controlled general practice trial of sertraline, exposure therapy and combined treatment in generalised social phobia. British Journal of Psychiatry 179, 23–30.CrossRefGoogle ScholarPubMed
Brambilla, F, Garcia, CS, Fassino, S, Daga, GA, Favaro, A, Santonastaso, P, Ramaciotti, C, Bondi, E, Mellado, C, Borriello, R, Monteleone, P (2007). Olanzapine therapy in anorexia nervosa: psychobiological effects. International Clinical Psychopharmacology 22, 197–204.CrossRefGoogle ScholarPubMed
Clark, DM, Ehlers, A, McManus, F, Hackmann, A, Fennell, M, Campbell, H, Flower, T, Davenport, C, Louis, B (2003). Cognitive therapy versus fluoxetine in generalized social phobia: a randomized placebo-controlled trial. Journal of Consulting and Clinical Psychology 71, 1058–1067.CrossRefGoogle ScholarPubMed
Cohen, JA, Mannarino, AP, Perel, JM, Staron, V (2007). A pilot randomized controlled trial of combined trauma-focused cbt and sertraline for childhood PTSD symptoms. Journal of the American Academy of Child & Adolescent Psychiatry 46, 811–819.CrossRefGoogle ScholarPubMed
Conrad, P (2007). The Medicalization of Society: On the Transformation of Human Conditions into Treatable Disorders. Baltimore, MD: The John Hopkins University Press.CrossRefGoogle Scholar
Davidson, JRT, Foa, EB, Huppert, JD, Keefe, FJ, Franklin, ME, Compton, JS, Zhao, N, Connor, KM, Lynch, TR, Gadde, KM (2004). Fluoxetine, comprehensive cognitive behavioral therapy, and placebo in generalized social phobia. Archives of General Psychiatry 61, 1005–1013.CrossRefGoogle ScholarPubMed
Dimidjian, S, Hollon, SD, Dobson, KS, Schmaling, KB, Kohlenberg, RJ, Addis, ME, Gallop, R, McGlinchey, JB, Markley, DK, Gollan, JK, Atkins, DC, Dunner, DL, Jacobson, NS (2006). Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. Journal of Consulting & Clinical Psychology 74, 658–670.CrossRefGoogle ScholarPubMed
Glenmullen, J (2006). Coming Off Antidepressants. London: Robinson PublishingGoogle Scholar
Harmer, CJ, Goodwin, GM, Cowen, PJ (2009). Why do antidepressants take so long to work? A cognitive neuropsychological model of antidepressant action. British Journal of Psychiatry 195, 102–108.CrossRefGoogle Scholar
Hedges, DW, Brown, BL, Shwalb, DA, Godfrey, K, Larcher, AM (2007). The efficacy of selective serotonin reuptake inhibitors in adult social anxiety disorder: a meta-analysis of double-blind, placebo-controlled trials. Journal of Psychopharmacology 21, 102–111.CrossRefGoogle ScholarPubMed
Hofmann, SG, Meuret, AE, Smits, JAJ, Simon, NM, Pollack, MH, Eisenmenger, K, Shiekh, M, Otto, MW (2006). Augmentation of exposure therapy with D-cycloserine for social anxiety disorder. Archives of General Psychiatry 63, 298–304.CrossRefGoogle ScholarPubMed
Hudson, JI, McElroy, SL, Raymond, NC, Crow, S, Keck, PE Jr., Carter, WP, Mitchell, JE, Strakowski, SM, Pope, HG Jr., Coleman, BS, Jonas, JM (1998). Fluvoxamine in the treatment of binge-eating disorder: a multicenter placebo-controlled, double-blind trial. American Journal of Psychiatry 155, 1756–1762.CrossRefGoogle ScholarPubMed
James, IM, Griffith, DN, Pearson, RM, Newbury, P (1977). Effect of oxprenolol on stage-fright in musicians. Lancet 5, 952–954.CrossRefGoogle Scholar
Keller, MB, McCullough, JP, Klein, DN, Arnow, B, Dunner, DL, Gelenberg, AJ, Markowitz, JC, Nemeroff, CB, Russell, JM, Thase, ME, Trivedi, MH, Zajecka, J (2000). A comparison of nefazodone, the cognitive behavioral-analysis system of psychotherapy, and their combination for the treatment of chronic depression. New England Journal of Medicine 342, 1462–1470.CrossRefGoogle ScholarPubMed
Lader, M (1983). Benzodiazepine withdrawal states. In: Benzodiazepines Divided (ed. Trimble, M. R.), pp. 17–32. New York: John Wiley & Sons.Google Scholar
Menzies, RPD (2009). Propranolol treatment of traumatic memories. Advances in Psychiatric Treatment 15, 159–160.CrossRefGoogle Scholar
NICE (2004). Anxiety: management of anxiety (panic disorder, with or without agoraphobia, and generalised anxiety disorder) in adults in primary, secondary and community care (http://www.nice.org.uk/CG22). National Institute for Health and Clinical Excellence.Google Scholar
NICE (2005). Obsessive-compulsive disorder: core interventions in the treatment of obsessive-compulsive disorder and body dysmorphic disorder (http://www.nice.org.uk/CG031). National Institute for Health and Clinical Excellence.Google Scholar
NICE (2007). Depression: management of depression in primary and secondary care (http://www.nice.org.uk/CG023). National Institute for Health and Clinical Excellence.Google Scholar
Ressler, KJ, Rothbaum, BO, Tannenbaum, L, Anderson, P, Graap, K, Zimand, E, Hodges, L, Davis, M (2004). Cognitive enhancers as adjuncts to psychotherapy: use of D-cycloserine in phobic individuals to facilitate extinction of fear. Archives of General Psychiatry 61, 1136–1144.CrossRefGoogle ScholarPubMed
Sandor, P (2003). Pharmacological management of tics in patients with TS. Journal of Psychosomatic Research 55, 41–48.CrossRefGoogle ScholarPubMed
Veale, D, Willson, R (2007). Manage Your Mood: Using Behavioural Activation to Manage Your Mood. London: Constable Robinson Publishing.Google Scholar
Wilhelm, S, Buhlmann, U, Tolin, DF, Meunier, SA, Pearlson, GD, Reese, HE, Cannistraro, P, Jenike, MA, Rauch, SL (2008). Augmentation of behavior therapy with D-cycloserine for obsessive-compulsive disorder [see comment]. American Journal of Psychiatry 165, 335–341; quiz 409.CrossRefGoogle ScholarPubMed
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